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    OpenPayerBilling CodesDiseases and Disorders of the Musculoskeletal System and Connective TissueDRG 450-single-level-spinal-fusion-except-cervical-with-mcc-or-custom-made-anatomically-designed-interbody-fusion-device
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    Single Level Spinal Fusion Except Cervical with MCC or Custom-Made Device: Inpatient Reimbursement Overview

    DRG 450 encompasses single level spinal fusion procedures outside the cervical region when a Major Complication or Comorbidity exists or a custom-made anatomically designed interbody fusion device is used, defining a higher-complexity inpatient cohort. This classification matters for inpatient reimbursement because it increases Medicare payment weights tied to surgical complexity, comorbidity burden, and specialized implant utilization.

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    DRG 450 Overview

    DRG 450 covers single level spinal fusion procedures performed on vertebral levels other than the cervical spine when a Major Complication or Comorbidity is present or when a custom-made anatomically designed interbody fusion device is used. This Diagnosis-Related Group captures higher-resource inpatient stays driven by the complexity of fusion surgery combined with significant comorbid illness or specialized implant use. It matters for Medicare payment because the presence of a Major Complication or Comorbidity or the use of a custom interbody device increases the relative weight and payment intensity under Medicare inpatient prospective payment systems. Accurate coding and documentation determine whether a case is assigned to this Diagnosis-Related Group and thus the appropriate inpatient reimbursement.

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    Clinical Trials

    • Acute perioperative optimization and complication-reduction trials: studies in this area evaluate protocols such as enhanced recovery after surgery (ERAS) pathways, perioperative blood management, infection prophylaxis strategies, and targeted pain-control regimens for adults undergoing single-level thoracolumbar spinal fusion with major complication risk (MCC). The patient population typically includes older adults or those with significant comorbidities (eg, diabetes, osteoporosis, obesity) who are at higher risk for intraoperative blood loss, wound infection, or cardiopulmonary events. These trials are relevant to providers and payers because reducing perioperative complications shortens length of stay, lowers intensive-care utilization, and decreases expensive readmissions and resource use associated with DRG 450 admissions.
    • Comparative effectiveness and device-outcome studies: head-to-head comparative studies assess different fusion techniques, bone graft materials, and anatomically designed interbody devices for single-level non-cervical fusion in patients with degenerative disc disease, spondylolisthesis, or spinal instability. These trials enroll patients indicated for single-level fusion to measure fusion rates, functional outcomes, reoperation rates, and procedure-related adverse events over 1–2 years, comparing outcomes and total cost of care across approaches. This research informs surgeons, hospital administrators, and payers about which surgical approaches or implant technologies yield better long-term outcomes and lower cumulative costs for the DRG population.
    • Post-discharge outcomes and utilization studies: longitudinal observational or pragmatic trials focus on recovery trajectories, rehabilitation intensity, opioid use patterns, and 30- to 90-day readmission or complication rates after discharge for patients who had single-level thoracolumbar fusion with MCC. Cohorts often include patients discharged to home with home health versus inpatient rehab, and track functional recovery, persistent pain, and healthcare utilization to identify predictors of costly post-acute care. Findings are important for care managers and payers to design discharge planning, rehabilitation pathways, and case management interventions that reduce readmissions and downstream expenditures associated with DRG 450.

    Related Codes

    402-SINGLE-LEVEL-COMBINED-ANTERIOR-AND-POSTERIOR-SPINAL-FUSION-EXCEPT-CERVICAL

    Single Level Combined Anterior and Posterior Spinal Fusion Except Cervical: Inpatient Reimbursement Overview

    426-MULTIPLE-LEVEL-COMBINED-ANTERIOR-AND-POSTERIOR-SPINAL-FUSION-EXCEPT-CERVICAL-WITH-MCC-OR-CUSTOM-MADE-ANATOMICALLY-DESIGNED-INTERBODY-FUSION-DEVICE

    Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical with MCC or Custom-Made Anatomically Designed Interbody Fusion Device: Inpatient Reimbursement Overview

    427-MULTIPLE-LEVEL-COMBINED-ANTERIOR-AND-POSTERIOR-SPINAL-FUSION-EXCEPT-CERVICAL-WITH-CC

    Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical with CC: Inpatient Reimbursement Overview

    428-MULTIPLE-LEVEL-COMBINED-ANTERIOR-AND-POSTERIOR-SPINAL-FUSION-EXCEPT-CERVICAL-WITHOUT-CC-MCC

    Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical without CC/MCC: Inpatient Reimbursement Overview

    429-COMBINED-ANTERIOR-AND-POSTERIOR-CERVICAL-SPINAL-FUSION-WITH-MCC

    Combined Anterior and Posterior Cervical Spinal Fusion with MCC: Inpatient Reimbursement Overview

    430-COMBINED-ANTERIOR-AND-POSTERIOR-CERVICAL-SPINAL-FUSION-WITHOUT-MCC

    Combined Anterior and Posterior Cervical Spinal Fusion without MCC: Inpatient Reimbursement Overview

    447-MULTIPLE-LEVEL-SPINAL-FUSION-EXCEPT-CERVICAL-WITH-MCC-OR-CUSTOM-MADE-ANATOMICALLY-DESIGNED-INTERBODY-FUSION-DEVICE

    Multiple Level Spinal Fusion Except Cervical with MCC: Inpatient Reimbursement Overview

    448-MULTIPLE-LEVEL-SPINAL-FUSION-EXCEPT-CERVICAL-WITHOUT-MCC

    Multiple Level Spinal Fusion Except Cervical without MCC: Inpatient Reimbursement Overview

    451-SINGLE-LEVEL-SPINAL-FUSION-EXCEPT-CERVICAL-WITHOUT-MCC

    Single Level Spinal Fusion Except Cervical without MCC: Inpatient Reimbursement Overview

    456-SPINAL-FUSION-EXCEPT-CERVICAL-WITH-SPINAL-CURVATURE-MALIGNANCY-INFECTION-OR-EXTENSIVE-FUSIONS-WITH-MCC

    Spinal Fusion Except Cervical with MCC: Inpatient Reimbursement Overview

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    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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